Traditional methods for translating EB information into clinical practice have not worked well, especially in underserved, multiethnic (vulnerable) communities. There is a scarcity of studies on effective dissemination methods in rural, frontier and impoverished areas. The concept of using health extension agents, patterned after the 100-year experience of the Agricultural Extension Service, which transformed farming in this country, has been suggested as a model for translating evidence-based information into primary care, but few studies of this model have been conducted. The long term goal of this proposal is for Health Extension Rural Office: Translating Research into Localities (HERO TRalLs) to build an efficient, sustainable infrastructure that can adapt deliver and evaluate methodology for translating evidence-based information into rural primary care practices serving rural, underserved, multiethnic populations. Three specific aims will be addressed: 1) To establish a sustainable HERO TRalLs infrastructure to rapidly develop and conduct dissemination interventions predicated on existing evidence-based tools, 2) To conduct a mixed-method, comparative effectiveness (CE) trial of two interventions for disseminating an evidence-based toolkit for treating chronic non-cancer pain (CNCP), in two rural Federally Qualified Health Center (FQHC) primary care practice systems in New Mexico, 3) To adapt and produce two dissemination manuals: a) health extension agent policies and procedures and b) an evidence-based CNCP treatment toolkit. A sustainable infrastructure will be molded by leveraging existing strengths and expanding the missions of three academic organizations: 1) the Health Extension Rural Offices (HEROs) based on the Agricultural Extension Service concept, 2) a state-wide practice-based research network, the Research Involving Outpatient Settings Network (RIOS Net), and 3) a community-oriented Clinical and Translational Science Center (CTSC). A Community Stakeholder Advisory Board will build research capacity with representatives from public health, a Medicaid managed care organization, a parent FQHC association, a Quality Improvement Organization, the Board of Pharmacy, and a community coalition. We will test the health exchange, practice detailing intervention in a CE trial using an adapted state-of-the-art EB toolkit for treating of CNCP.